The value of renal score in both determining surgical strategies and predicting complications for renal cell carcinoma: A systematic review and meta‐analysis

Abstract

Objectives: Radical nephrectomy (RN) was the standard treatment for renal cell carcinoma (RCC). However, recent studies have found that partial nephrectomy (PN) could achieve similar effects as radical nephrectomy, and has the advantages of less bleeding and shorter hospital stay. The choice of surgical strategies has become a concern of clinicians, which could be guided by renal score introduced by Kutikov et al Therefore, we conducted this meta-analysis to clarify the value of renal score of determining surgical strategies and predicting complications. Methods: The keywords "RENAL score," "renal nephrometry score," or "nephrometry score" were used to retrieve electronic databases for relevant literature up to Feb 2020, including PubMed, Web of Science, and the Cochrane library. Surgical strategies and complications are outcome measures. Risk ratio (RR) with 95% confidence intervals (CI) is applied to assess the effect size. Results: A total of 20 studies met the selection criteria for meta-analysis. There was significant difference in RN operation rate for each subgroup (low-moderate: RR = 3.50, 95% Cl = 2.60-4.71, P < .001; low-high: RR = 6.29, 95% Cl = 4.40-9.00, P < .001; moderate-high: RR = 1.80, 95% Cl = 1.39-2.32, P < .001).The overall incidence of complications from high renal score group was significantly higher than that in low renal score group (low-moderate: RR = 1.32, 95% Cl = 1.03-1.69, P = .026; low-high: RR = 2.45, 95% Cl = 1.48-4.07, P = .001; moderate-high: RR = 1.75, 95% Cl = 1.17-2.61, P = .007). Conclusions: This meta-analysis indicated that renal score is an efficient tool for determining surgical strategies and predicting complications in PN. More prospective research is essential to verify the predictive value of renal score. K E Y W O R D Scomplications, meta-analysis, Renal cell carcinoma, RENAL score, surgical strategiesThis is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

The role of imaging in the management of renal masses

“…The RENAL nephrometry score, assigns tumor with a score depending on points gathered from the (R)adius of the tumor, the (E)xophytic/endophytic nature, the (N) earness to the collecting system or sinus, the (A)nterior(a)/posterior(p) descriptor, and the (L)ocation relative to the polar line. Various publications have confirmed correlation of RENAL nephrometry score with surgical decision making, surgical complications, postoperative functional outcomes, histologic factors such as stage, grade, and cancer-specific survival rates [34].…”

“…Various nephrometry scores (RENAL, Padua, c-index) have been used to quantify this expected difficulty [34]. The RENAL nephrometry score, assigns tumor with a score depending on points gathered from the (R)adius of the tumor, the (E)xophytic/endophytic nature, the (N) earness to the collecting system or sinus, the (A)nterior(a)/posterior(p) descriptor, and the (L)ocation relative to the polar line.…”

Early and Late Postoperative Complications in Patients With Localized and Locally Advanced Renal Cell Carcinoma

“…The standard of treatment for localized and locally advanced RCC is radical nephrectormia [4]. rate of patients.…”

“…The main method of treating RCC is radical nephrectomy [4]. The principles of performing radical nephrectomy include early ligation of the renal artery and vein, removal of the kidney along with the surrounding paranephral tissue, and the ipsilateral adrenal gland.…”

The Role of Imaging in the Management of Renal Masses

“…Various nephrometric scores (RENAL, Padua, c-index) have been used to measure this expected difficulty [34]. RENAL nephrometry score, assigning tumors to a score depending on points collected from (R)adius tumor, (E)xophytic/endophytic nature, (N)earness to the collecting system or sinuses, (A)interior (a)/posterior(p) descriptor, and (L)location relative to the polar line.…”